만성 알코올리즘 환자의 임상적, 전기진단학적 평가

Clinical and Electrophysiological Study in Chronic Alcoholic Patients

Background: Peripheral neuropathy is a frequent complication of chronic alcoholic patients. This study was to evaluate nutritional status, electrophysiological study, and to correlate alcohol history with Toronto Clinical Neuropathy Scoring System (TCNSS) and nutritional parameters. Methods: The study involved 34 patients aged 56.7±10.6 years who were diagnosed as chronic alcoholism according to DSM-IV criteria. Alcohol history was evaluated with multiplying Standard Drink (SD) with duration (year) of alcohol abuse and it was 495.24±384.81 (SD*years). Electrophysiological studies including sensory and motor conduction, H-reflex, F-wave were performed. TCNSS combines information obtained from score of symptoms, reflex test, sensory test. For nutritional status, laboratory test included hemoglobin, mean corpuscular volume (MCV), folate, albumin in blood. Results: Electrophysiological studies showed small amplitude of sensory nerve action potential in 5 (5.8%) cases of median nerve, 14 (41.1%) and 13 (38.2%) cases of superficial peroneral and sural nerve. For motor conduction studies, 3 (8.8%) and 3 (8.8%) cases of peroneal and tibial compound muscle action potential showed small amplitude. H-reflex of onset latency showed abnormal in 17 (50%) cases and F-wave of onset latency showed abnormal in 15 (44.1%) cases. Laboratory evaluation shows 2 (5.8%) cases of low hemoglobin, and 6 (17.6%) cases of low albumin level. There were no significant correlations between alcohol history and TCNSS, nutritional parameters. Conclusion: This study showed that nerve conduction studies were abnormal about half of the patients and sensory fibers are more frequently involved, especially in the lower limbs, mostly axonal neuropathy. Serum albumin deficiency was the most frequent abnormal nutritional parameter. There were no correlations between alcohol history and Toronto Clinical Neuropathy Scoring System, nutritional parameters.